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Delayed cord clamping does not affect umbilical cord blood gas analysis

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Although delayed umbilical cord clamping has been shown to have significant benefits for both term and preterm infants, currently, data on its impact on blood gas analysis have been scant and conflicting.

Methods

In a retrospective review, we compared the demographic characteristics and blood gas parameters of 114 delayed cord clamping (DCC—births between 45 and 90 s in length; 109 being for 60 s) versus 407 early cord clamping births (ECC—immediately after delivery) collected over a 1-year period. Intrapartum care and timing of cord clamping for individual cases were performed at the discretion of obstetricians. The differences were assessed for statistical and clinical significance.

Results

The DCC group was found to have significantly higher mean Apgar scores at both 1 and 5 min (p < 0.05), as well as lower percentages of nulliparous births, cesarean-section deliveries, epidural anesthesia usage, and major pregnancy-related complications. No significant differences in maternal age, gestational age, neonate birthweight, sex, or in the presence of meconium at birth were observed. A higher umbilical artery pO2 in the DCC group [21 (9) vs. 19 (10) mmHg, p < 0.05] was the only statistically significant difference found out of all the blood gas parameters analyzed.

Conclusions

In this study, infants selected for the DCC procedure were found to be overall lower risk than those delivered as per the standard ECC procedure. No clinically significant difference in any blood gas parameter was observed, and therefore, no adjustment to clinical reference intervals is needed for DCC blood gas samples taken after a 1-min delay period.

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Authors and Affiliations

  1. Department of Laboratory Medicine, Dr. Everett Chalmers Regional Hospital, Horizon Health Network, Fredericton, NB, E3B 5N5, Canada

    Jiachen Tang, Rachel Fullarton & Yu Chen

  2. Faculty of Science, University of New Brunswick, Fredericton, NB, Canada

    Jiachen Tang

  3. Department of Obstetrics and Gynecology, Dr. Everett Chalmers Regional Hospital, Horizon Health Network, Fredericton, NB, Canada

    Sheri-Lee Samson

  4. Department of Obstetrics and Gynecology, Dalhousie University, Halifax, NS, Canada

    Sheri-Lee Samson

  5. Department of Pathology, Dalhousie University, Halifax, NS, Canada

    Yu Chen

Authors
  1. Jiachen Tang
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  2. Rachel Fullarton
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  3. Sheri-Lee Samson
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  4. Yu Chen
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Contributions

YC and S-LS contributed to the conception of the project. JT and RF collected data. JT and YC did data analysis and drafted the original manuscript. YC, S-LS, and RF critically revised the manuscript for intellectual content. All of the authors approved the final version to be published and agreed to act as guarantors of the work.

Corresponding author

Correspondence to Yu Chen.

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Conflict of interest

No potential conflict of interest relevant to this manuscript was reported.

Ethical standards

All DCC and ECC cases of vigorous term and preterm infants between February 2017 and February 2018 were retrospectively reviewed with a study protocol approved by the Institute Research Ethics Board (File #: 2018-2614). Maternal and neonatal demographic variables including maternal and gestational age, parity, mode of delivery, epidural anesthesia usage, neonate birthweight, Apgar scores at 1 and 5 min, sex, presence of meconium at birth, and major pregnancy-related complications (including gestational diabetes mellitus, chorioamnionitis, and cholestasis, etc.), were pulled from medical records and compared.

Informed consent

Informed consent was waived with the approval of the Research Ethics Board of Horizon Health Network.

Human and animal rights statement

This article does not contain any studies with animals performed by any of the authors.

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Tang, J., Fullarton, R., Samson, SL. et al. Delayed cord clamping does not affect umbilical cord blood gas analysis. Arch Gynecol Obstet 299, 719–724 (2019). https://doi.org/10.1007/s00404-019-05048-5

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  • DOI: https://doi.org/10.1007/s00404-019-05048-5

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